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Retiree Insurance
2014 Monthly Insurance Premium Rates

Monthly premiums may be automatically deducted from the PERS, TRS, or LEOFF subscriber benefit checks. UW Retirement Plan (UWRP) subscribers may make arrangements for monthly automatic deduction from a bank account. Download Electronic Debit form.

Life Insurance

The life insurance self-pay rate for subscribers is $6.57 per month.

Medical Rates Without Medicare

Classic & Value Plans

Members not eligible for Medicare (or enrolled in Part A only):
Uniform Medical Plan Classic Group Health Classic Group Health Value Kaiser Permanente Classic
Subscriber
$551.03
$589.19
$537.04
$588.43
Subscriber & Spouse/QDP
1,095.84
1,172.16
1,067.86
1,170.64
Subscriber & Child(ren)
959.64
1,026.42
935.16
1,025.09
Full Family
1,504.45
1,609.39
1,465.98
1,607.30

Consumer-Driven Health Plan with Health Savings Account (CDHP/HSA)

Members not eligible for Medicare (or enrolled in Part A only):
Uniform Medical CDHP/HSA Group Health CDHP/HSA Kaiser Permanente CDHP/HSA
Subscriber
$504.56
$500.69
$503.93
Subscriber & Spouse/QDP*
999.94
992.20
998.18
Subscriber & Child(ren)*
890.68
883.91
889.20
Full Family*
1,327.73
1,317.09
1,325.12

Medical Rates for Medicare Retirees Enrolled in Part A and Part B

Members enrolled in Part A & B of Medicare: # Medicare Eligible Uniform Medical Plan Classic Group Health Medicare Plan Group Health Classic Group Health Value Kaiser Permanente Classic
Subscriber Only
$223.87
$144.79
N/A*
N/A*
$152.99
Subscriber & Spouse/QDP
1
768.68
N/A*
$727.76
$675.61
735.20
Subscriber & Spouse/QDP
2
441.52
283.36
N/A*
N/A*
299.76
Subscriber & Child(ren)
1
632.48
N/A*
582.02
542.91
589.65
Subscriber & Child(ren)
2
441.52
283.36
N/A*
N/A*
299.76
Full Family
1
1,177.29
N/A*
1,164.99
1,073.73
1,171.86
Full Family
2
850.13
N/A*
720.59
681.48
736.42
Full Family
3
659.17
421.93
N/A*
N/A*
446.53

*If a Group Health subscriber is enrolled in Medicare Part A and Part B but covers a family member not eligible for Medicare, the family member must enroll in a Group Health Classic or Value plan and the subscriber pays a combined Medicare and non-Medicare rate.

Medicare Supplement Plan F, administered by Premera Blue Cross

 

Plan F

Age 65 or older

eligible by age

Plan F

Under age 65

eligible by disability

Subscriber Only
$106.37
$196.74

Subscriber & Spouse/QDP

1 Medicare eligible

651.18
741.55

Subscriber & Spouse/QDP

2 Medicare eligible - 1 retired, 1 disabled

296.89
296.89

Subscriber & Spouse/QDP

2 Medicare eligible

206.52
387.26

Subscriber & Child(ren)

1 Medicare eligible

514.98
605.35

Full Family

1 Medicare eligible

1,059.79
1,150.16

Full Family

2 Medicare eligible - 1 retired, 1 disabled

705.50
705.50

Full Family

2 Medicare eligible

615.13
795.87

*If a Medicare supplement plan is selected, non-Medicare eligible dependents are enrolled in the Uniform Medical Plan (UMP) Classic. The rates shown reflect the total due, including premiums for both plans. Medicare rates shown above have been reduced by the state-funded contribution up to the lesser of $150 or 50 percent of plan premium per retiree per month.

Dental Rates When Enrolled in Medical*

  Uniform Dental Plan** DeltaCare** Willamette Dental
Subscriber Only
$44.72
$39.53
$43.23
Subscriber & Spouse/QDP
89.44
79.06
86.46
Subscriber & Child(ren)
89.44
79.06
86.46
Full Family
134.16
118.59
129.69

**Uniform Dental Plan and the DeltaCare Plan are administered by Washington Dental Service.

QDP = Qualified Domestic Partner

Retiree Insurance Topics